The impact of respiratory muscle training on respiratory function in patients with neuromuscular disease: a systematic review and meta-analysis of randomized controlled trials

Abstract Background Neuromuscular diseases (NMDs) can impair respiratory muscle function, leading to increased morbidity and mortality. Respiratory muscle training (RMT) is widely used to manage these respiratory complications, but its efficacy across different NMDs remains unclear. This systematic...

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Main Authors: Nancy Yesenia Ortiz-Garcia, Diego Eduardo Rueda-Capristran, Ajay Kumar, Domenica Alejandra Herrera, Angie Carolina Alonso-Ramírez, Diana Othón-Martínez, Jonathan Reyes-Rivera, Frances Marie Mejia, Jonathan David Martinez-Illan, Carla Isabella Miret Durazo, Elda Janette Perez-Moreno, Camila Sánchez Cruz, Ernesto Calderon Martinez
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Sports Science, Medicine and Rehabilitation
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Online Access:https://doi.org/10.1186/s13102-025-01198-z
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author Nancy Yesenia Ortiz-Garcia
Diego Eduardo Rueda-Capristran
Ajay Kumar
Domenica Alejandra Herrera
Angie Carolina Alonso-Ramírez
Diana Othón-Martínez
Jonathan Reyes-Rivera
Frances Marie Mejia
Jonathan David Martinez-Illan
Carla Isabella Miret Durazo
Elda Janette Perez-Moreno
Camila Sánchez Cruz
Ernesto Calderon Martinez
author_facet Nancy Yesenia Ortiz-Garcia
Diego Eduardo Rueda-Capristran
Ajay Kumar
Domenica Alejandra Herrera
Angie Carolina Alonso-Ramírez
Diana Othón-Martínez
Jonathan Reyes-Rivera
Frances Marie Mejia
Jonathan David Martinez-Illan
Carla Isabella Miret Durazo
Elda Janette Perez-Moreno
Camila Sánchez Cruz
Ernesto Calderon Martinez
author_sort Nancy Yesenia Ortiz-Garcia
collection DOAJ
description Abstract Background Neuromuscular diseases (NMDs) can impair respiratory muscle function, leading to increased morbidity and mortality. Respiratory muscle training (RMT) is widely used to manage these respiratory complications, but its efficacy across different NMDs remains unclear. This systematic review and meta-analysis evaluated the impact of physiotherapy interventions, specifically RMT, on respiratory muscle function in NMD patients. Methods A systematic search of multiple databases, including MEDLINE, EMBASE, Web of Science, Cochrane, CRS-Web, PEDro, LILACS, ICTPR, the China National Knowledge Infrastructure database, and ClinicalTrials.gov, was conducted up to February 2025. Randomized controlled trials (RCTs) and cohort studies evaluating RMT’s effect on lung volumes and respiratory muscle strength in NMD patients were included. Risk of bias assessment was performed using Cochrane Risk of bias tool for RCTs and Newcastle-Ottawa Scale for cohorts. Meta-analyses were performed using a random-effects model, and heterogeneity was assessed with I² statistics. Results Sixteen studies were analyzed from 9,626 screened articles. The meta-analysis demonstrated significant improvements in respiratory muscle strength, particularly in maximal inspiratory pressure (MD: 6.83 cmH₂O, 95% CI: 2.08 to 11.58, p < 0.01, I² = 3.8%) and maximal expiratory pressure (MD: 13.05 cmH₂O, 95% CI: 3.65to 22.42, p < 0.01, I² = 43%). No significant improvements were observed in forced vital capacity (MD: 3.13%, 95% CI: -8.06 to 14.34, p = 0.58), sniff nasal inspiratory pressure (MD: 1.47 cmH₂O, 95% CI: -15.45 to 18.39, p = 0.86), forced expiratory volume in one second (MD: -0.02 L, 95% CI: -0.17 to 0.13, p = 0.78), and vital capacity (MD: -0.10 L, 95% CI: -0.31 to 0.11, p = 0.33). Conclusion This review supports the role of respiratory muscle training in improving inspiratory and expiratory muscle strength in patients with neuromuscular diseases. However, variability in study methodologies and patient populations limits the statistical significance of some respiratory parameters. Future studies should aim to standardize interventions and outcome measures to provide more conclusive evidence on the efficacy of RMT.
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spelling doaj-art-0100cda116d3496296a509b3558fe0f22025-08-20T03:03:45ZengBMCBMC Sports Science, Medicine and Rehabilitation2052-18472025-07-0117111210.1186/s13102-025-01198-zThe impact of respiratory muscle training on respiratory function in patients with neuromuscular disease: a systematic review and meta-analysis of randomized controlled trialsNancy Yesenia Ortiz-Garcia0Diego Eduardo Rueda-Capristran1Ajay Kumar2Domenica Alejandra Herrera3Angie Carolina Alonso-Ramírez4Diana Othón-Martínez5Jonathan Reyes-Rivera6Frances Marie Mejia7Jonathan David Martinez-Illan8Carla Isabella Miret Durazo9Elda Janette Perez-Moreno10Camila Sánchez Cruz11Ernesto Calderon Martinez12Universidad Juárez del Estado de DurangoUniversidad Nacional Autónoma de MéxicoIsra University Faculty of Medicine and Allied Medical SciencesPontificia Universidad Católica de EcuadorPontificia Universidad JaverianaUniversity of Texas Rio Grande ValleyUniversidad Autónoma de San Luis PotosíYale New Haven Health Bridgeport HospitalUniversidad del NoresteCentro de Estudios Universitarios XochicalcoUniversidad Nacional Autónoma de MéxicoUniversidad Nacional Autónoma de MéxicoThe University of Texas Health Science Center at HoustonAbstract Background Neuromuscular diseases (NMDs) can impair respiratory muscle function, leading to increased morbidity and mortality. Respiratory muscle training (RMT) is widely used to manage these respiratory complications, but its efficacy across different NMDs remains unclear. This systematic review and meta-analysis evaluated the impact of physiotherapy interventions, specifically RMT, on respiratory muscle function in NMD patients. Methods A systematic search of multiple databases, including MEDLINE, EMBASE, Web of Science, Cochrane, CRS-Web, PEDro, LILACS, ICTPR, the China National Knowledge Infrastructure database, and ClinicalTrials.gov, was conducted up to February 2025. Randomized controlled trials (RCTs) and cohort studies evaluating RMT’s effect on lung volumes and respiratory muscle strength in NMD patients were included. Risk of bias assessment was performed using Cochrane Risk of bias tool for RCTs and Newcastle-Ottawa Scale for cohorts. Meta-analyses were performed using a random-effects model, and heterogeneity was assessed with I² statistics. Results Sixteen studies were analyzed from 9,626 screened articles. The meta-analysis demonstrated significant improvements in respiratory muscle strength, particularly in maximal inspiratory pressure (MD: 6.83 cmH₂O, 95% CI: 2.08 to 11.58, p < 0.01, I² = 3.8%) and maximal expiratory pressure (MD: 13.05 cmH₂O, 95% CI: 3.65to 22.42, p < 0.01, I² = 43%). No significant improvements were observed in forced vital capacity (MD: 3.13%, 95% CI: -8.06 to 14.34, p = 0.58), sniff nasal inspiratory pressure (MD: 1.47 cmH₂O, 95% CI: -15.45 to 18.39, p = 0.86), forced expiratory volume in one second (MD: -0.02 L, 95% CI: -0.17 to 0.13, p = 0.78), and vital capacity (MD: -0.10 L, 95% CI: -0.31 to 0.11, p = 0.33). Conclusion This review supports the role of respiratory muscle training in improving inspiratory and expiratory muscle strength in patients with neuromuscular diseases. However, variability in study methodologies and patient populations limits the statistical significance of some respiratory parameters. Future studies should aim to standardize interventions and outcome measures to provide more conclusive evidence on the efficacy of RMT.https://doi.org/10.1186/s13102-025-01198-zNeuromuscular conditionsPhysical therapy modalitiesPulmonary functionRespiratory function testsMuscle strengtheningRespiratory therapy
spellingShingle Nancy Yesenia Ortiz-Garcia
Diego Eduardo Rueda-Capristran
Ajay Kumar
Domenica Alejandra Herrera
Angie Carolina Alonso-Ramírez
Diana Othón-Martínez
Jonathan Reyes-Rivera
Frances Marie Mejia
Jonathan David Martinez-Illan
Carla Isabella Miret Durazo
Elda Janette Perez-Moreno
Camila Sánchez Cruz
Ernesto Calderon Martinez
The impact of respiratory muscle training on respiratory function in patients with neuromuscular disease: a systematic review and meta-analysis of randomized controlled trials
BMC Sports Science, Medicine and Rehabilitation
Neuromuscular conditions
Physical therapy modalities
Pulmonary function
Respiratory function tests
Muscle strengthening
Respiratory therapy
title The impact of respiratory muscle training on respiratory function in patients with neuromuscular disease: a systematic review and meta-analysis of randomized controlled trials
title_full The impact of respiratory muscle training on respiratory function in patients with neuromuscular disease: a systematic review and meta-analysis of randomized controlled trials
title_fullStr The impact of respiratory muscle training on respiratory function in patients with neuromuscular disease: a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed The impact of respiratory muscle training on respiratory function in patients with neuromuscular disease: a systematic review and meta-analysis of randomized controlled trials
title_short The impact of respiratory muscle training on respiratory function in patients with neuromuscular disease: a systematic review and meta-analysis of randomized controlled trials
title_sort impact of respiratory muscle training on respiratory function in patients with neuromuscular disease a systematic review and meta analysis of randomized controlled trials
topic Neuromuscular conditions
Physical therapy modalities
Pulmonary function
Respiratory function tests
Muscle strengthening
Respiratory therapy
url https://doi.org/10.1186/s13102-025-01198-z
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